Basic Information
| Provider Information | |||||||||
| NPI: | 1780794149 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | GALVAN | ||||||||
| FirstName: | DAN | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 WALLACE BLVD | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791061708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8064149558 | ||||||||
| FaxNumber: | 8063564673 | ||||||||
| Practice Location | |||||||||
| Address1: | 503 N 21ST ST | ||||||||
| Address2: | |||||||||
| City: | CAMP HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170112204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177632100 | ||||||||
| FaxNumber: | 7177632401 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 06/22/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0102X | J2018 | TX | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | J2018 | PA | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | J2018 | TX | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 100161010 A | 05 | OK | MEDICAID | 00075602 | 05 | NM | MEDICAID | 127497907 | 05 | TX | MEDICAID | 127497906 | 05 | TX | MEDICAID |